Individual
DR. CARRIE MARELL BRADFORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
12251 S 80TH AVE, PALOS HEIGHTS, IL 60463-1256
(708) 923-5148
(708) 923-5067
Mailing address
520 E 22ND ST, LOMBARD, IL 60148-6110
(708) 923-5148
(708) 923-5067
Taxonomy
Speciality
Code
Description
License number
State
207ZC0500X
Cytopathology Physician
Primary
036.120823
IL
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
336.081983
IL
Other
Enumeration date
07/07/2008
Last updated
09/12/2016
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